Abstract
Background.
Understanding the factors that influence language recovery in aphasia
is important for improving prognosis and treatment. Chronic
comprehension impairments in Wernicke’s aphasia (WA) are associated with
impairments in auditory and phonological processing, compounded by
semantic and executive difficulties. This study investigated whether the
recovery of auditory, phonological, semantic, or executive factors
underpins the recovery from WA comprehension impairments by charting
changes in the neuropsychological profile from the subacute to the
chronic phase.
Method. This study used a prospective,
longitudinal observational design. Twelve WA participants with superior
temporal lobe lesions were recruited 2 months post–stroke onset (2 MPO).
Language comprehension was measured alongside a neuropsychological
profile of auditory, phonological, and semantic processing and
phonological short-term memory and nonverbal reasoning at 3 poststroke
time points: 2.5, 5, and 9 MPO.
Results. Language comprehension
displayed a strong and consistent recovery between 2.5 and 9 MPO.
Improvements were also seen for slow auditory temporal processing,
phonological short-term memory, and semantic processing but not for
rapid auditory temporal, spectrotemporal, and phonological processing.
Despite their lack of improvement, rapid auditory temporal processing at
2.5 MPO and phonological processing at 5 MPO predicated comprehension
outcomes at 9 MPO. Conclusions. These results indicate that
recovery of language comprehension in WA can be predicted from fixed
auditory processing in the subacute stage. This suggests that speech
comprehension recovery in WA results from reorganization of the
remaining language comprehension network to enable the residual speech
signal to be processed more efficiently, rather than partial recovery of
underlying auditory, phonological, or semantic processing abilities.
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